Huge condyloma of Bushke-Levenstein
Huge condyloma of Bushke-Levenstein (kartsinomopodobny peaked condyloma) — the kind of a peaked condyloma differing in the progressing growth, the big sizes and a persistent retsidivirovaniye after the carried-out treatment. It is characterized by the expressed ekzofitny and endofitny growth with destruction of surrounding fabrics, a possibility of regeneration in planocellular cancer of skin. The diagnosis of a huge condyloma of Bushke-Levenstein is based on her clinical picture and demands histologic confirmation which is carried out after removal of a tumor. Treatment consists in full excision of a condyloma against the background of the all-strengthening and antiviral therapy, local introduction of interferon and bleomycin.
Huge condyloma of Bushke-Levenstein
The huge condyloma of Bushke-Levenstein meets both in young, and at senile age. Most often it is observed at men and settles down on a penis. Less often development of a condyloma is noted on genitals of women. Ekstragenitalny localization can take place.
The huge condyloma of Bushke-Levenstein along with Bowen's disease, a bovenoidny papulez, Keyr's disease, a pigmentary xeroderma and a skin horn belongs to precancer new growths of skin. Its transformation in cancer of skin can be promoted by bad personal hygiene, decrease in immunity, the long irritating influence of external factors.
Reasons of a huge condyloma of Bushke-Levenstein
Emergence of a huge condyloma of Bushke-Levenstein is caused by the virus of papilloma of the person (VPP). The travmatization, immunosupression, , the increased perspiration, sexually transmitted infections (ureaplasmosis, clamidiosis, a cytomegalic inclusion disease) are considered as the factors contributing to its emergence. In venereology separate cases of development of a huge condyloma of Bushke-Levenstein against the background of red flat were observed depriving also of a scleroatrophic likhen.
Symptoms of a huge condyloma of Bushke-Levenstein
The disease begins with emergence on skin of the small educations similar to papillomas, warts or peaked condylomas. These elements quickly increase in sizes and merge with each other, forming the uniform site of defeat - a huge condyloma of Bushke-Levenstein. It has the wide basis covered with the fleecy growths and vegetations divided by the expressed grooves. On the periphery of education the isolated peaked condylomas are observed. Over time vegetations expand, become covered by scales of the horny epithelium and matserirutsya. In the grooves passing between them accumulates separated, having an unpleasant smell. Often there is an infection therefore separated gains purulent character.
Most often the huge condyloma of Bushke-Levenstein is localized on a penis in the field of its head or a coronal furrow. Its emergence in anorektalny area, around an anus, in a groin, on skin of vulvar lips and a clitoris at women, on a face (on cheeks, around a mouth, in the field of a century or a nose), on a mucous oral cavity or urinogenital bodies is possible.
The huge condyloma of Bushke-Levenstein differs in the slow, steadily progressing growth and tendency to a retsidivirovaniye. Together with the expressed ekzofitny growth of a huge condyloma of Bushke-Levenstein leading to its growth as "cauliflower" the expressed germination in surrounding fabrics is observed. The progressing growth of education can lead to destruction of extreme flesh, introduction of a tumor in kavernozny bodies, to germination of adjacent fabrics with formation of fistulas and ulcerations. Perhaps ozlokachestvleny a huge condyloma with its transition to planocellular cancer of skin.
Diagnosis of a huge condyloma of Bushke-Levenstein
The diagnosis of a huge condyloma is established by the venereologist. For this purpose he performs inspection of education and its differential diagnostics with diseases, similar on manifestations: peaked condylomas, wide condylomas, oral papillomatoz, anogenitalny kondilomatoz, planocellular cancer of skin, characteristic of secondary syphilis. Conduct in addition PTsR-researches on VPCh.
Only data of histology of the material removed during surgical treatment allow to make the final diagnosis of a huge condyloma of Bushke-Levenstein. For an exception of malignant transformation of a condyloma the research is conducted with several samples of fabric taken from various sites of a tumor. The histologic picture at a huge condyloma of Bushke-Levenstein has similarity to a picture of a usual peaked condyloma and differs only in bigger degree of expressiveness of pathological changes. The expressed increase in thickness of a horn layer of epidermis and germination of a condyloma in deep layers terms is observed. A sign of malignant transformation is detection of the sites of tumoral fabric corresponding to a histologic picture of cancer in situ.
Treatment of a huge condyloma of Bushke-Levenstein
Considering invasive and rapid growth of a huge condyloma, a possibility of its transformation in cancer, its broad surgical excision is recommended. Operation has to be performed after detection of a tumor in the nearest future. For prevention of a postoperative recurrence of a huge condyloma of Bushke-Levenstein additional cryodestruction of the basis of a tumor is recommended.
Surgical treatment is combined with the system antiviral and all-strengthening therapy. A number of authors indicates expediency of local introduction of interferon, their inductors and bleomycin in the postoperative period.
X-ray therapy of a huge condyloma is contraindicated as it can give an impetus to cancer transformation of a tumor.
The forecast at a huge condyloma of Bushke-Levenstein
Despite the full and absolutely correctly carried out treatment, the huge condyloma of Bushke-Levenstein can recrudesce. Its malignant transformation is observed in terms from 2 to 12 years after developing of a disease.